Foot

Question 1

ROM

Question 2

OTTAWA rules

Answer 2

1. Bony tenderness along distal 6 cm of posterior edge of fibula or tip of lateral malleolus
2. Bony tenderness along distal 6 cm of posterior edge of tibia/tip of medial malleolus
3. Bony tenderness at the base of 5th metatarsal
4. Bony tenderness at the navicular
   Inability to bear weight both immediately after injury and for 4 steps during initial evaluation

Question 3

Ankle anterior drawer test

Answer 3

MCL and LCL, excessive motion/pain = damage
prone knee bent
hands in U over front and back of ankle
stabilise tibia and PA on talus
do in PF and DF

Question 4

Talar tilt test

Answer 4

Prone
U grip on talus, just below lateral malleolus, other hand gripping foot
adduct foot to end feel
laxity of calcaneo-fibular lig = excessive ROM + pain

Question 5

Accessory ankle mvmts

Answer 5

@ subtalar joint, talocrural joint, inferior tib-fib joint.

Question 6

Tib-Fib Passive accessory ROM

Answer 6

prone, knee bent
PA - block tibia with U grip in front, move fibula at lateral malleolus with heal of hand.
AP - block tibia with U grip from the back and AP through heal from front of lat malleolus

Question 7

Talocrural passive accessory ROM

Answer 7

prone, knee bent
AP - stabilise tibia at back with U grip and apply AP on talus
PA - block ant of tibia and PA on post aspect of talus (quite high up)
note end feel, symptoms, R1, 2
traction and compression - prone, ent knee, my bent leg on their thigh for traction

Question 8

sub-talar joint passive accessory

Answer 8

side lying, rolled towel under foot
medial glide - one hand over talus and other grabbing calcaneous to apply med glide
lateral glide - patient flips, one hand over talus and other grabbing calcaneous to apply lat glide

Question 9

Inter-tarsal joints Passive accessory - navicular

Answer 9

navicular (medial)
- AP w both thumbs on bone and rest of fingers around to hold (supine)
-PA through navicular and stabilise laterally

Question 10

Inter-tarsal joints Passive accessory - cuboid

Answer 10

cuboid (lateral)
- AP stabilise medial and use palm to AP cuboid (supine)
- PA through palm/thumbs on cuboid and stabilise medially

rolled towel on

Question 11

Bones of the foot

Answer 11

cuboid - lateral
navicular - medial, front of talus
cuneiforms - 3, medial to cuboid
talus - under tib and fib
calcaneus - under talus (heal)

metatarsals, phalanges (d, m, p)

Question 12

Passive accessory ROM in forefoot - Tarsal-metatarsal joint

Answer 12

stabilise middle cuneiform with U grip medially (at joint line, up from metaT), AP on first metaT with other thumb.
PA in same position.
same with other metaTs by stabilising corresponding tarsal bones

Question 13

Passive accessory ROM in forefoot - intermetatarsals

Answer 13

stabilise one and PA or AP on the one next to it

Question 14

Passive accessory ROM in forefoot - Metatarsal-phalangeal joint

Answer 14

Grasp metatarsal with thumb and wrap hand medially
apply AP/PA on proxi phalanx with other hand

Question 15

Passive accessory ROM in forefoot - interphalangeal joint

Answer 15

stabilise proximal one and PA or AP on distal one

Question 16

MWM - inversion

Answer 16

to restore inversion
AP on fiibula with their active inversion of ankle.
1. assess ROM, note reaxn
2. AP fib
3. active inversion (maintaining AP)
4.overpressure
5. active return
6. let go
repeat for rx

Question 17

WB MWM - DF of talo-crural joint

Answer 17

patient step forward in stride stance
apply AP on talus, while active DF by bending knee forward.
only release pressure when they’re back in neutral.